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Does your child have allergies? Children's Hospital can help

By Johy Kelly, The Washington Post

Posted:
12/04/2013 05:29:06 AM MST

Food allergies are on the rise in children, a new study shows. (Getty Images)

One morning in October, Jasibi Crew-West of Clinton, Md., found herself in an odd position: For all three years of her son Justin's life, she'd been telling him that peanuts could kill him. Now she wanted him to eat a cracker dabbed with a dollop of peanut butter.

Justin was born with extreme food allergies. Jasibi noticed it from her earliest days breast-feeding him, when Justin would experience a badly upset stomach and break out in eczema. Blood tests and prick tests — where tiny amounts of potential allergens are scratched into the skin — had revealed Justin's allergies to shellfish, dairy, soy, tree nuts, ground nuts and eggs.

His is an increasingly common story.

“Food allergies are absolutely on the rise,” said Hemant Sharma, associate chief of allergy and immunology at Children's National Medical Center in Washington, where Justin is treated. “A recent study showed they affect about one in 13 kids in the United States. That's about two children in every single classroom.”

One study suggests that peanut allergies have tripled in the past decade.

Doctors understand the mechanism of the allergic reaction — an antibody called immunoglobulin E goes berserk in its overzealous attempts to vanquish what it thinks is a dangerous invader — but they aren't sure why there's been such an explosion.

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“The short answer is we don't exactly understand why yet,” Sharma said. “There are a lot of researchers investigating various theories.”

One possibility is what's called the hygiene hypothesis. With modern houses so clean, babies aren't exposed to as many infectious agents as in the past. In some people, the body's immune system trains its weapons on harmless foods instead.

Such an ability may have proved useful in our distant past, when the body needed to combat parasites. Today, food allergies cause hives, wheezing, a swelling in the throat and a dangerous drop in blood pressure — all signs of anaphylactic shock.

Justin had a close call when he was 2. His parents — Jasibi is a third-grade teacher; dad Husani Tony West owns a hobby shop in Waldorf, Md. — were out for the evening and Grandma was watching Justin and his older sister, Sophia. Justin ate some store-bought ginger cookies that contained egg.

When his parents returned home, Justin had thrown up and was wheezing. “I immediately knew this is not okay,” Jasibi said. She gave him Benadryl and called 911.

“As soon as they got here, they said, 'Thank goodness you called.' ”

Some kids will outgrow their allergies. Justin has had two food “challenges”: controlled doses of allergens in a hospital setting, in his case dairy and milk. Justin wasn't sure what to think at first.

“A lot of the children who come in, they've been used their entire life to being told you have to stay away from this food at all costs or you could have a fatal reaction,” Sharma said. “For them to come in and be told, 'Eat a little bit of this,' there's a big leap. They have to overcome that anxiety.”

At Children's Hospital, psychologists are part of the team, helping kids understand what's off limits — and why a doctor might ask them to go ahead and eat it. In fact, once a child is no longer allergic to a certain food, it's important for them to be exposed to it occasionally, lest the reaction return.

Justin passed his milk and peanut challenges. This Halloween, he had his first peanut M&Ms.

Of course, the bigger challenge is living every day with food allergies. Justin is still severely allergic to egg. His teachers know what he can't eat. He has a special pantry at school. Jasibi makes him Rice Krispie treats to eat when other kids are having cake. She's become adept at whipping up egg-free cakes herself.

“Children die from this,” she said. “My kid could have died from this. It's really, really scary.”

Justin understands the stakes.

Said Jasibi: “When someone offers him something, he says, 'They have eggs? They have eggs?' He waits for them to say yes or no. When I give him something he says, 'They have eggs?' If he's asking me, then I know he's asking everyone.”

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